'Too hungry to think'

Stockton-on-Tees GP Dr Paul Williams was one of a group of health professionals and campaigners who lived off £5 and a bag of food for a week - the amount the Mary Thompson Fund gives to failed asylum seekers in hardship - to show solidarity and understanding those refused asylum.
Read more about his attempt. Here are some excerpts from the diary he kept

SundayUnlike everyone else, I was due to start today at 11am. (There was no way that the people I play 5-a-side football with on a Saturday morning were going to let me off without paying the £3 match fee). At 11.30am I ambled along to the newsagent to buy the Sunday paper. As I was handing over £1.50 I suddenly realised that this was almost a third of my weekly budget. Beans on toast for lunch wasn't too bad, but I noticed the absence of margarine and pepper. We met some friends at the David Lloyd sports club (cost about £50 per month) for badminton, a swim, then a games of tennis doubles. Failed asylum seekers certainly don't have the privilege of playing indoor tennis and swimming in a heated outdoor pool in January. Nor do they have a £40 tennis racket, £30 badminton racket, trainers, swimming trunks, goggles and all the other equipment needed for a sporting life.

On the way home we stopped at Safeway. The car needed filling up with petrol for work (£40 spent, but somehow not counted in the weekly budget). We bought porridge oats, pasta, potatoes, reduced bread (29p) and rolls (29p), reduced carrots (10p a bag), reduced sausages (45p for 8), reduced beans (25p) and reduced salmon (99p for two). As Vicky, my partner, and I are both doing the "£5 and a bag of food week" we're pooling resources. We bought two litres of milk that will have to last for the whole week. Dinner was grilled salmon with potatoes, carrots and beans. The only thing I have been without today is alcohol.

MondayUp at 7am for porridge after a good night's sleep (helped by the absence of any alcohol, no doubt). It was icy cold outside, but the thermostat-controlled central heating in our house had kept us warm in bed. I missed having a cup of tea, and drove to work. I spent the day seeing patients from Zimbabwe, Democratic Republic of the Congo, Iran, Iraq, Afghanistan and Liberia. After listening to stories of death, rape and war I felt so lucky to be living a comfortable life in a safe country. I wolfed down the pasta, sausage and sweetcorn salad that I'd made for lunch. In the afternoon I listened to a mother with her baby who have been cowering in a house in Stockton at night, terrified whilst racists outside shouted and threw bricks though the window.

As the afternoon continued my hunger increased. Normally I have snacks mid-afternoon. Biscuits, crisps, anything! I found a banana in the office at 5.30pm and ate that. After work I had a game of squash booked. I play in a league, and couldn't face the embarrassment of trying to explain why I couldn't pay - so coughed up £2.80. Dinner was fish cakes - an old recipe that my mum makes by mixing mashed potato and sardines - fried in lots of oil with baked beans. It was filling enough, but I would have enjoyed a beer with it. By 9.30pm I was exhausted, and after a shower lay on the bed to read, but the book only kept my attention for 10 minutes. I don't normally get to sleep before midnight . . .

TuesdayI have had a headache all day, presumably as a result of caffeine withdrawal. Porridge greeted me again for breakfast. I spent the morning in my practice teaching medical students. Three people seeking asylum came in to tell their stories to the students and explore the effect of the asylum process on health. Our third "patient" gave a harrowing account of his involvement in one of Africa's civil wars. He described being imprisoned for months by soldiers during which time he was hit with sticks, tied up and repeatedly raped. It was obvious to all present that he was clearly telling the truth, but his asylum case failed due to "lack of evidence". Here was a man actually living on £5 per week. He still wore the same clothes that he had on when I saw him last week. He told us how he relied on friends for a bed, and had slept on the streets and in a toilet. He was only 19.

After lunch of soup and a roll I facilitated a seminar at the University of Durham, involving medical and social work students talking about team-working and dealing with professional inadequacy. After a 40-length swim I met two friends in the pub on the way home, and had to work hard to resist their attempts to buy me drinks. The rules that we have agreed say that we can't rely on other people's hospitality for food or drink - as failed asylum seekers usually don't have wealthy friends to buy them dinner and drinks. At home Vicky had made a sausage, tomato and kidney bean casserole with rice. I'm going without snacks, but am managing to go to bed without feeling hungry. Watched a bit of the football on the TV (Sky costs more than £30 per month) and checked emails using broadband (£30 per month) on my laptop computer. I'm well aware that most of the things that I need to live a comfortable life are already paid for, or go through on direct debit so I never notice the money.

WednesdayPorridge again for breakfast, and a drive to BBC Radio Cleveland for an interview on the breakfast programme. It cost £1 to park, but I have not been counting travel expenses in the £5 that I have had to survive on. Obviously we are not just doing the "£5 and a bag of food week" just for the experience. We want to explain to a wider audience that people whose asylum claims fail are not "bogus": they have often suffered imprisonment, rape, torture, war and bereavement, but are either unable to prove it or cannot demonstrate that it would happen again if they were returned to their country; often can't be sent home because their countries are too dangerous (Iraq, Somalia, Zimbabwe); and that they live in poverty under our noses. They are not allowed to work, and if it were not for the Mary Thompson Fund giving them £5 and a bag of food, and tiny amounts from faith groups, they would literally go hungry.

Into work where I spent the morning writing medical reports for patients who wanted evidence of beatings or torture for court cases. I resisted offers of coffee, and had lunch of baked potato, tuna and sweetcorn. Most of the afternoon was spent meeting the director of public health and other representatives of the primary care trust who were on a routine visit to the practice to check on the quality of the service that we are providing. We had corned beef hash for dinner with baked beans, before I drove to play 5-a-side football. My team won, but I wasn't able to avoid paying the £3 subs. By 10.30pm I was in bed, as I had an early start.

Thursday

I left the house at 5.45am with a bowl of porridge that I ate in the car at the traffic lights. I caught the 6.30am train to London for a sitting of the health select committee. The government is trying to make all non-urgent primary care ineligible to failed asylum seekers. I have already heard stories of pregnant women in London being denied antenatal care because they could not pay, and people with HIV being told that they could not have treatment. The select committee was looking at the impact of denying NHS HIV treatment to what they call "overseas visitors". I wanted to be at the hearing to widen the debate to other types of healthcare. My ticket to London (£110) was bought last week, but I reflected on how differently I travelled to my patients. Whereas they take the overnight bus for £20 and take seven hours - to see friends and relatives, or to get legal advice - I was able to arrive in London in two and a half hours. On arriving at Portcullis House where the select committee meets, I was devastated to see a sign on the door prohibiting food and drink. My packed lunch and a bottle of water were in my bag, but I couldn't take them in. I tried negotiating with the security man on the door - explaining my predicament - but he was having none of it. I had to scoff several carrots and drink my water, and then place a plastic tub full of rice and tuna in the dustbin.

The MPs only accepted the economic and "public health" arguments that HIV treatment should be provided for free on the NHS. I wandered up towards Trafalgar Square, where I cheated on the "£5 and a bag of food week" by having a bowl of soup and a roll for £2.75. After the disappointments of losing my lunch and the morning's events I needed some nourishment. I caught the 3pm train, and by 5.45pm I was not only back in the north-east, but was having a swim in the David Lloyd pool. With the energy (and a certain guilt) from the soup I swam 64 lengths before driving home. I ate some of the sausage casserole left over from Monday before spending a couple of hours answering the 40 emails that I had received.

FridayUp at 7am for porridge and drove to meet with the health visitor and practice nurse that I work with. Saw some patients for a couple of hours, then drove to James Cook hospital where my medical students gave an entertaining and informative presentation to their peers entitled Who Wants To Be A Refugee? They used the game show format to put across some serious points about the health problems that people seeking asylum have - including living on £38.96 a week (for an adult over 25, younger people get less), not being allowed to work, and living in some of the tougher neighbourhoods. I was proud to see that some of the group had changed their minds about asylum seekers.

I met some of the rest of the group doing the "£5 and a bag of food" week at the North of England Refugee Service - there are nine of us - over a lunch of spicy corn chowder that Vicky had made. We realised that we had all managed adequately, but only because of all of the other comforts that we had in our lives.

I had a busy afternoon clinic booked, and spent a long time with a new patient from the Congo. She had just been moved to the area, and was clearly very frightened and traumatised. She had been raped and told me that she had "many problems in her heart", with tears in her eyes.

By the end of the afternoon I was hungry. "Too hungry to think," I remember saying. I swam another mile in the pool, then weighed myself. I was surprised that I now weighed 71.9kg. I had lost 1.7kg (3.7lbs) in six days. I bought some mince, an onion, some mushrooms and some reduced-price sausages with the last of the money on the way home, and cooked a chilli con carne for dinner. It would have been nicer with a glass of red wine. Got a text from Pete who has also been doing the "£5 and a bag of food week". He apologised for having "given up" on the alcohol front, but I wanted to continue for a bit longer. We watched The Big Lebowski, a film by the Coen brothers, on DVD before another early night. I don't think I've ever had so much sleep in a week as this one (except on holiday).

SaturdayHad porridge (for the last time!). Drove to Newcastle to meet with a group of professionals working with refugees. This morning's topic was Suicide And Alienation'. None of my patients have yet committed suicide, but every week I have someone tell me that they would rather end their life in the UK on their own terms than be sent back to their own country.

In a towerblock close to the centre of Newcastle I spent one and a half hours with a man from Cameroon listening to him telling me how he was imprisoned, repeatedly beaten on the back with a piece of rubber tyre, beaten on the soles of his feet with a baton, and then made to run up and down over broken rocks in his underpants. The tears in his eyes as he was talking said much more to me than the fading scars on his back. As a doctor trained in the medico-legal documentation of torture, I see one or two people each week to take testimony and record their scars, giving an independent opinion as to the likelihood of the scars being sustained in the manner described. Almost all the people I see are telling the truth, but sometimes the worst forms of torture leave only psychological scars that are much harder to prove.

By 2.30pm I was at a friend's house, and four of us (including Vicky) walked to St James Park where we watched one of Newcastle United's better performances of the season (beating Coventry 3-1). I had bought the tickets (£21 each) a few weeks ago, but how many failed asylum seekers ever get to go to FA Cup matches? Ate the sausage sandwiches that Vicky had brought. After a week of abstinence, when Nick suggested a quick trip to the pub on the way home I gave in. He kindly bought us a drink.